WHO has published Poliomyelitis - Democratic Republic of the Congo. Excerpt:
As of October 2018, genetically-linked circulating vaccine-derived poliovirus type 2 (cVDPV2) isolates were detected in two cases from Haut-Katanga province (Mufunga-Sampwe district) in the Democratic Republic of the Congo. The first case was a 11-year old child who experienced onset of acute flaccid paralysis (AFP) on 6 October. The second case was a 29-month old child who experienced onset of symptoms on 7 October, and is a known contact of the first case.
The isolated viruses are a new emergence and unrelated to previously-detected cVDPV2s affecting the country. This is the fourth distinct outbreak of cVDPV2 detected in the country since June 2017. In total, 42 cVDPV2 cases have now been confirmed since detection of the first outbreak in June 2017, 20 cases of which were detected in 2018.
Public health response
In February 2018, the government declared cVDPV2 to be a national public health emergency. On 26 July 2018, the Minister of Health, WHO Director General, the Regional Director for Africa, and provincial governors convened an urgent, high-level meeting and signed the ‘Kinshasa Declaration for Polio Eradication’. Provincial governors pledged to provide the necessary oversight, accountability and resources required to urgently improve the quality of the outbreak response being implemented across the country. It is imperative that the remaining operational gaps in outbreak response are urgently filled with the appropriate oversight and engagement.
WHO and partners are responding in accordance with international outbreak response protocols including through administration of monovalent oral polio vaccine type 2 (mOPV2). However, operational gaps such as the under-immunization of high-risk populations, continue to hamper the full implementation of these protocols. Thus, the response so far has not adequately controlled the outbreak nor prevented its spread.
The recent emergence of the fourth outbreak of cVDPV2 from Haut Katanga can potentially be attributed to the prior use of mOPV2 and may be related to the response program’s current limited capacity to adapt effectively and implement necessary corrective measures in a timely manner.
With the evidence of geographic spread of some of these strains and emergence of the new strain, two large scale rounds of mOPV2 were administered in September 2018 and October 2018 targeting around 12 million children in 16 of 26 provinces of the country. Surveillance and immunization activities continue to be strengthened in the Democratic Republic of the Congo and neighboring countries.
The polio outbreak response is being conducted simultaneously to the ongoing Ebola outbreak affecting North Kivu province to the east of the country. Polio outbreak response teams are coordinating closely with the broader humanitarian emergency network, to ensure both outbreaks are addressed in a coordinated manner.
